One in 10 Americans who died last week were killed by flu — more than from opioid addiction or breast cancer. The 2018 flu outbreak is on track to rival the swine flu epidemic of 2009, which made 60 million Americans sick, hospitalized more than a quarter of a million and killed more than 12,000.

Of course, this epidemic is not the fault of the Trump administration, any more than 2009’s H1N1 outbreak was the fault of President Barack Obama’s White House. What does fall in the president’s lap is the fact that we are confronting this current challenge without a confirmed director of the Centers for Disease Control and Prevention, with a number of states — with encouragement from the Trump administration — instituting work requirements for Medicaid coverage, which widens gaps in coverage, and, above all, with no leadership from the White House on the flu response.

And that, sadly, is no surprise.

During our last two infectious-disease crises — the Ebola epidemic in 2014 and the Zika outbreak in 2015 and 2016 — Donald Trump’s xenophobic, divisive and antiscience instincts were on display to horrible effect. As Obama mustered a response to Ebola in West Africa — to save lives and to contain the disease — Trump repeatedly tweeted that the United States should cut off overseas response efforts, decline treatment to an American evangelical doctor who had contracted the disease, and reject standard scientific protocols. During the Zika outbreak, an apathetic Trump backed anti-immigrant lawmakers who delayed funding for a federal response — leading to the first-ever cases of the disease being contracted in the United States. And after Trump’s election, he met with antivaccine activists — building on a history of tweets that baselessly tied autism to vaccination rates.

While President Trump’s key early appointees in this area — Health and Human Services Secretary Tom Price and CDC director Brenda Fitzgerald — departed from the president’s worst instincts on pandemic prevention, both were felled by ethical issues. Trump himself has been mum on the flu; it appears to be the one of the few topics in public life on which he has nothing to say. America will get through this year’s epidemic without him, but what about the major threat that looms on the horizon: a deadly pandemic flu? Here, Trump’s terrible instincts and attitudes could be catastrophic.

How bad could such a pandemic be? 2018 marks the 100th anniversary of the 1918 Spanish flu, which killed more than 600,000 Americans — more than World Wars I and II combined. Doctors today have more tools to combat such an outbreak, but our increased interconnectedness means we face a greater threat of rapid spread than we did a century ago. As a result, modern science will do less to protect us from a flu pandemic than most people suspect.

Our best defense against such a pandemic reaching our shores is an investment in global health security: stopping diseases overseas. But the Trump administration has undertaken a stunning reversal of 16 years of progress under President George W. Bush and Obama. The massive government funding bill approved in mid-February slashed funds for the CDC’s Prevention and Public Health Fund. Team Trump recently announced deep cuts to global health funding rooted in the Ebola epidemic, implementing an 80 percent reduction in the global reach to detect infectious-disease outbreaks abroad. Trump’s newly released budget proposal would wreak more havoc by cutting another $1 billion from the CDC.

Such an “America First” mind-set toward health security is dangerous. Disengaging from the world not only turns our back on humanitarian needs abroad — it also increases the risk that those crises will reach our shores. Because of rapid international travel, an outbreak in a remote village in China or a forest in Africa can lead to disease transmission in a U.S. urban center within 24 hours, and in any town in our country hours later. Before we even know the threat has arrived, our emergency rooms could be overwhelmed. And no, MAGA Nation, a giant wall along our southern border will not protect us.

It doesn’t have to be this way. For a fraction of what the president wants to spend on his pointless barrier with Mexico, we could make ourselves infinitely safer from infectious diseases. The president could quickly close the leadership hole at CDC by nominating its senior career official, Anne Schuchat, to the top job. He could back plans for a Public Health Emergency Fund that both Democrats and Republicans in Congress have supported. He could put pandemic preparedness and response on his agenda for this year’s G-20 meeting in Buenos Aires.

And if all that is too much, he could wake up tomorrow morning and simply tweet: “Experts say everybody should get a flu shot this year and I agree.” If the president won’t put his head or heart into pandemic prevention, maybe he could at least put his thumbs to good use for once.